Non traumatic osteonecrosis of the femoral head is a disease of imparied osseus blood flow followed to a collapse of the femoral head progressive loss of articular cartilage and worsening pain. Osteonecrosis has been associated with corticosteroid intake, excessive alcohol use, Gaucher disease, intraosseus lipid deposition, hypersensitivity reaction, Shwartzman reaction and condition associated with tromboplastin release including malignant tumors and inflammatory bowel disease. The most comnion sympton is a deep pain in the groin which increases with the clinical maneuvers of internal rotation of the hip and decrease during extrarotation, decreased range of motion and clicking in the hip when necrotic fragment has collapsed. Radiographic studies can show osteopenia, cysti, sclerosis, subchondral collapse, flattening of femoral head and progressive loss of the joint space and the RNM present a 99% sensitive and specific. The authors reviewed the long term results of core decompression and borrage for the treatment of nontraumatic osteonecrosis of the femoral head in Stage I, II and II/III of Ficat and Arlet performed from 1980 in the Orthopaedic Clinic of Trieste University.
